The Role of Medicine in the Development of Early Greek Science

wel DEERX The Role of Medicine in the Development of Early Greek Science R., The role of medicine in Ihe development of early Greek science: et le traitement des maladies, les écrits médicaux nous renseignent sur les mpas VIII 1975 327-333. | Par le développe:nent des idées sur les causes arguments employés pour dégager la science de la superstition,et sur les facved 1 teurs qui encouragèrent l'emploi des méthodes empiriques. + There are three principal strands to Greek science in the period from the sixth to the fourth century B.C., namely philosophy — that is, chiefly, physical and cosmological speculation— mathematics and medicine. The evidence for the first two of these is scanty, that for pre-Platonic mathematics being worse even than that for pre-Platonic philosophy, both in the number and extent of the extant fragments, and in the general reliability of the interpretative comments of later sources. The position as regards medicine is far more favourable in that we have, in the Hippocratic Corpus, a substantial body of original texts most of which date from the fifth or fourth century B.C, Much notable work towards evaluating Hippocratic medicine has recently been done by Joly, Kudlien, Lanata and others!, following, and often modifying the conclusions of, earlier studies by scholars such as Heidel, Edelstein and Bourgey?. Yet from some points of view the use of this material for the study of certain key probiems in the development of Greek science can be said to have only just begun. In particular the Hippocratic evidence can provide insights into aspects of the social background to the development of Greek science, and can be used to help define the nature of the Greek achievement in initiating the Western scientific tradition, in ways that have yet to be fully exploited. What developed in Greece in the sixth to the fourth centuries B.C. was not ‘science’ as such, so much as the three largely distinct® disciplines that | have identified, philosophy, mathematics and medicine. There are important differences, both as between these three fields, and as between different individuals working in the same field, in the views that were taken of the nature of the investigations they engaged in. In philosophy — as | have argued elsewhere* — so far as the earlier Presocratics down to Parmenides are concerned, it is fairly clear that none of them placed himself in any category of ‘philosopher’ or ‘inquirer into nature’ that included all the others, and it is even uncertain how far any of them saw themselves as part of a single developing investigation, even though they were often aware of one another's ideas. In medicine, the texts of the Hippocratic Corpus were evidently written by men of very different types, with different social roles and different conceptions of the nature of medicine. The influence of rhetoric and the sophistic movement is marked in a number of treatises, some of which may well have been composed by men who were professional sophists or teachers, rather than practising doctors. On the other hand others were clearly produced by and for medical practitioners. Again several borrow ideas freely from contemporary cosmology: but others, notably On Ancient Medicine, strongly criticise what they represent as the intrusion of philosophical ideas and, especially, methods into medicine. Whereas philosophy as such

did not provide a livelihood until it came to be a subject that was taught for a fee, th. doctors by contrast could always earn a living (or suppleme nt their income) both from, cosmologists there is at least one, namely Empedocles, who so far from always insisting the practice of medicine and from teaching, where the taught might include not only on naturalistic explanations himself claimed, in one fragment, to be able to control the intending practitioners but also men who wished to learn about such subjects as th weather and even to bring the dead back to life”. But we have again to turn to the with, or ascribed to, the gods or supernatural agencies — although among later Presocratic constitution of the human body and the causes of diseases as part of their genera) education”. Moreover such works as On the Nature of Man throw medical writers for extended original texts explicitly criticising supernaturalist explanalight on the context in tions. which some scientific discussion was conducted. Evidentl y such topics as the constituent elements of the human body or those of physical objects as a whole could be, and sometimes were, the subject of public debates, with The author of On the Sacred Disease, especially}! , mounts a sustained attack on those who thought that the ‘sacred disease’ — that is, epilepsy — was Caused by divine agency opposing speakers each attempting to and could be cured by ritual purifications. Now the reports of anthropologists show that persuade a lay audience who adjudicated the result by declaring the winner“. Although there is nothing unusual about doubts being expressed concerning particular witchthis was, of Course, not the only form that such discussi ons took, this evidence helps to explain both the predominant role of argument in, and the ‘agonistic’ or competitive character of, some Greek scientific writings. The chief point that must be emphasised is the fragment doctors, diviners, wise men and the like. Evans-Pritchard, for example, remarks on this in his classic study of the Azande'” . Yet Evans-Pritchard went on to note that the Zande rejection of individual witch-dectors, so far from being accompanied by scepticism about ary nature of early Greek science, witch-doctorhood in general, tends to confirm that belief: ‘scepticism explains failures of the variety of heads under which what we may call scientific inquiry was conducted. witch-doctors, and being directed towards particular witch-doctors even tends to support There was no role for the scientist as such, and much of what we know as faith in others’! . What is exceptional in On the Sacred Disease is the general attack on early Greek science was done by men who saw themselves primarily as, for example, doctors oı teachers. The pluralism of Greek science had certain advantage s in the very variety of methods and aims of investigators who had different primary interests. Thus if knowledge for its own sake was often the goal of the philosop hers, the doctors, by contrast, tended to show a greater interest in the practical applicability, and the testability, of the: theories. At the same time the attendant, and probably more important, disadvantage was that there was no framework for the discussion of the nature of science or scientific method as such, It is characteristic that one of our most important early texts on method, the treatise On Ancient Medicine, is largely concerned with what we may call a demarcation dispute between philosophy and medicin e’. Apart from illuminating certain aspects of the social backgrou nd to early Greek science, spells and incantations can have any effect either on the course of diseases or on any other natural phenomena’ . Moreover it is not the case that, in attacking the beliefs of the ‘purifiers’, the Hippocratic author had — we should say — any clear idea of the causes of epilepsy (where he develops a largely fanciful notion of the effects of phlegm blocking the ‘veins’ in the body) or that he had any effective remedy for it'® (although he claims that this, as indeed every other disease, can be cured by adjusting the balance of opposites in the patient's regimen)'®. To judge from this evidence, the general rejection of this set of supernaturalist beliefs depended not on the availability of alternative, more effective means of dealing with the problem to which those beliefs related, but on the development of a new conception of nature that excluded any idea of direct divine intervention in the Hippocratic texts provide evidence that helps to define the nature of the Greek natural phenomena. achievement in this field. We speak of the Greeks Originating or inventing the Western But if this treatise provides important direct evidence concerning the precise form that scientific tradition itself, but precisely what this means is often certain arguments against magical or superstitious beliefs took, the study of other aspects usually focussed on speculative philosophy, on the contrast Se the beliefs of the ‘purifiers’ that diseases can be caused by supernatural agencies, and that left unclear, Attention is between the cosmologies of the earlier Presocratics and pre-philosophical mythologies. But the medical texts serve to elucidate other aspects of the problem, and the evidence of medicine has the particular advantage of the possibility of contro/: we can make direct comparisons not only between different conceptions of medicine within the Greek world, but also between the Greeks and their ancient near Eastern neighbours*, or again between the Greeks and what anthropologists have reported from moder n societies, _ One aspect of the development of science that has often been stressed is the substitution of rational for mythical explanations of natural phenomena. Whilst the large number of accounts of earthquakes, lightning and thunder and so on that are attributed to the early are) Presocratics in our late Secondary sources may partly reflect a bias in those secondary 9 6 sources themselves”, the early philosoph ers do indeed appear to have been particularly interested in marvellous phenomena, many of which had traditionally been associated RrAesDnEnRreTE: : of Greek medicine helps to define the limits of what was achieved in this respect. The attempt to refute ‘magic’, both inside and outside'” medicine, was at most only partially successful, The idea that gods can cause diseases, though rejected by certain Hippocratic authors, survived not only in popular belief, but also among the educated" . Although On the Sacred Disease dismisses the use of spells and purifications, their effectiveness, and that of amulets and prayers, continued to be controversial topics on which the medical writers themselves adopted opposing positions"? . It was not only the followers of Asclepius who held that dreams can be used in diagnosis and sometimes indicate the treatment to be followed, for we find examples of both beliefs from the Hippocratic work On Regimen right down to Galen*”. The terms ‘magic’ (aye la) and “charla: tanry’ (&4Aatoveta) were frequently used to express what any particular writer disapproved of, but what counted as ‘magic’ varied considerably from one writer to another?! .

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